Holguin v. Harris

• Decision Date: 14 November 1979
• Docket Number: No. C-78-2486-CBR.,C-78-2486-CBR.
• Citation: 480 F. Supp. 1171
• Court: U.S. District Court — Northern District of California
• Parties: Librado HOLGUIN, Plaintiff, v. Patricia R. HARRIS, Secretary of Health, Education, and Welfare, Defendant.

480 F. Supp. 1171

Librado HOLGUIN, Plaintiff, v. Patricia R. HARRIS, Secretary of Health, Education, and Welfare, Defendant.

No. C-78-2486-CBR.

United States District Court, N. D. California.

November 14, 1979.

COPYRIGHT MATERIAL OMITTED

Alfredo M. Morales, La Casa Legal De San Jose, Santa Clara, Cal., for plaintiff.

G. William Hunter, U. S. Atty., William T. McGivern, Jr., Asst. U. S. Atty., San Francisco, Cal., for defendant.

ORDER GRANTING SUMMARY JUDGMENT

RENFREW, District Judge.

Plaintiff brought this action pursuant to 42 U.S.C. § 405(g) to obtain judicial review of a final decision of the Secretary of Health, Education, and Welfare (HEW) denying his claim for disability insurance benefits under Title II of the Social Security Act,¹ and for supplemental security income (SSI) under Title XVI of the Act. See 42 U.S.C. §§ 416(i)(1), 423, 1381a. Both parties have filed motions for summary judgment. After having carefully considered the memoranda of points and authorities and other pleadings in this case, including the transcript of the April 13, 1978 hearing before Administrative Law Judge Herz (ALJ), this Court concludes that the Secretary's decision is supported by substantial evidence and that no good cause has been shown requiring a remand² of the case to the administrative body. The decision of the Secretary is therefore affirmed.

Plaintiff was injured in an automobile accident on November 10, 1975. Since the accident, he has complained of headache, neck, knee, and back pains, and further, alleges an inability to return to work because of these ailments. During this period, he has been treated continuously for these complaints by his physician, Dr. Buso. Plaintiff was diagnosed on November 12, 1976, as having suffered cervical and lumbosacral strain, as well as severe contusions to both knees. He was treated with Dexamethasone and Cortisone injections and physical therapy. There was no radiation pattern associated with the pain reported, but limitations of the neck and trunk movements, muscle spasm, and tenderness throughout the neck, back, and lumbosacral spine area were reported. Subsequent diagnosis on May 23, 1977 reported all conditions recurrent and worsening. A final diagnostic report on March 23, 1978, reported all plaintiff's ailment conditions sufficiently severe to limit him to light and sedentary activities and to disable him permanently from his usual occupation.

A consulting physician, Dr. Martell, after examination on September 15, 1977, found some mild cervical and lumbosacral strain, but attributed plaintiff's persisting disability to other conditions. The consulting physician found no significant abnormalities of the spine or the extremities, with neurological responses registering within normal limits. Some hyperalgesia was found along the neck, lower back, and knees. However, X-rays revealed no arthritic changes to support plaintiff's complaints. Dr. Martell recommended that psychological and internal support and motivation to return to work as well as better attention to control of plaintiff's diabetes and hypertension would eliminate plaintiff's disability.

Medical records, from 1972, document a history of diabetes and hypertension, over which plaintiff has achieved varying degrees of control, but which could be controlled through prescribed medication and diet.

Plaintiff is a 54 year old male, with a third grade Mexican education, who communicated in English at the hearing with the assistance of an interpreter. He is well nourished and alert, with some exogenous fat. He has worked as a farm laborer, dishwasher, railroad worker, musician and photographer. At the time of the accident, he was employed as a free-lance photographer and musician.

Plaintiff testified that his main limitations are associated with arthritic pains in the knees, back of the neck, and shoulders. While Codeine controls his arthritic type joint pains, it does not relieve his back discomfort. He is unable to sit for long periods without experiencing pain, and these symptoms further limit his ability to squat, bend, or lean forward. He describes his daily activities as limited largely to reading, watching television in his home, attending church several times a week, and occasionally walking around the house and yard to relieve his back. Plaintiff has never been hospitalized for these ailments.

Plaintiff filed an application for a period of disability and disability insurance benefits on August 30, 1976, alleging onset of a disability on November 10, 1975. Plaintiff also filed an application for SSI on September 2, 1976. Both applications were denied initially, and both applications were denied on reconsideration on June 17, 1977. Plaintiff made a timely request for, and obtained, a hearing before an ALJ on July 6, 1977. Plaintiff, represented by counsel and communicating through an interpreter, testified to his physical condition and presented records of past hypertension and diabetes, hypertension diagnosis and treatment, work history, and diagnoses of primary and consulting physicians.

On May 30, 1978, the ALJ determined that plaintiff was disabled, as defined by the Social Security Act, from November 10, 1975 until September 15, 1977, and was, therefore, entitled to benefits for that period. Pursuant to 42 U.S.C. § 405(g), plaintiff challenges that decision.

Courts engage in two levels of review for HEW disability benefit decisions. See 42 U.S.C. §§ 405(g), 1383(c)(3). The first can be called substantiality of the evidence review and the second, remand review. Section 405(g) of the United States Code, § 205(g), of the Social Security Act as amended, reads in part:

"Any individual, after any final decision of the Secretary made after a hearing to which he was a party * * * may obtain a review of such decision by a civil action * * *. The federal district court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Secretary, with or without remanding the cause for a rehearing. The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive * * *."

This review limits the Court to the single question of whether or not the findings of the Secretary of HEW are supported by substantial record evidence. Chavies v. Finch, 443 F.2d 356, 357 (9 Cir. 1971); Dean v. Gardner, 393 F.2d 327, 328 (9 Cir. 1968). "Substantial evidence" is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971) quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 83 L.Ed. 126 (1938).

Ordinarily, a plaintiff must establish that he is and remains unable to return to his customary employment. Rhinehart v. Finch, 438 F.2d 920, 921 (9 Cir. 1971); Seitz v. Secretary of Social Security Administration, 317 F.2d 743, 744 (9 Cir. 1963). However, if he does so, the burden of producing evidence shifts to the Secretary to prove that the claimant is capable of performing other forms of substantial gainful activity which exists in the national economy, unless evidence already in the record establishes this capability. If the Government meets this burden, the claimant then bears the overall burden of demonstrating that his disability precludes substantial gainful employment. Meneses v. Secretary of Health, Education and Welfare, 143 U.S.App. 81, 84, 442 F.2d 803, 806 (1971). See Kerr v. Richardson, 387 F.Supp. 361, 363 (E.D.Cal.1974).

While most cases just involve the first level or substantiality of evidence review, § 405(g) also authorizes federal courts to engage in a second level of review with much looser standards upon a sufficient showing. Under this level or remand review, "the court * * * may, at any time, on good cause shown, order additional evidence to be taken before the Secretary * * *." HEW regulations specifically require the hearing examiner to "inquire fully into the matters at issue and to receive in evidence the testimony of witnesses and any documents which are relevant and material to such matters." 20 C.F.R. § 404.927.

The Court can therefore order a remand even if a claimant failed to produce substantial evidence of disability at the administrative hearing. Factors relevant to "good cause" for remand include (1) the weight of lay evidence of medical impairments in the absence of adequate medical evidence, Cooney v. Finch, 300 F.Supp. 818, 821 (W.D.Pa.1969), (2) the existence of new evidence which "`bears directly and substantially on the matter in dispute,'" Kemp v. Weinberger, 522 F.2d 967, 969 (9 Cir. 1975); (3) the ready obtainability of existing or potential new evidence, Heisner v. Sec'y of HEW, 538 F.2d 1329, 1332 (8 Cir. 1976); Hess v. Sec'y of HEW, 497 F.2d 837, 840-841 (3 Cir. 1974); (4) the development of the evidence by the hearing examiner, Landess v. Weinberger, 490 F.2d 1187, 1189 (8 Cir. 1974); Tillman v. Weinberger, 398 F.Supp. 1124, 1128 (N.D.Ind.1975); Cooney v. Finch, supra, 300 F.Supp. at 821; and (5) the specificity of the findings of the hearing examiner concerning relevant issues, Miranda v. Sec'y of HEW, 514 F.2d 996, 999 (2 Cir. 1975).³

This Court feels that there is sufficient information in the record and that it is incumbent on the Court to make such determination. By adopting the "good cause" standard for remand to take additional evidence, Congress instructed the courts to exercise broad discretion in their view of administrative denials of benefits, Kerner v. Flemming, 283 F.2d 916, 922 & n.9 (2 Cir. 1960). One can infer from this grant of discretion a desire to give claimants the fullest scope of entitlement protection, and the courts must follow that mandate. Parker v. Califano, 441 F.Supp. 1174, 1179 (N.D.Cal.1977). To do less would be to deny plaintiff the full scope of protection.

SUBSTANTIALITY OF THE...